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JACC. Cardiovascular Interventions Sep 2019
Topics: Heart Rupture, Post-Infarction; Humans; Myocardial Infarction; Treatment Outcome
PubMed: 31537283
DOI: 10.1016/j.jcin.2019.06.010 -
European Heart Journal Dec 2016
Topics: Aged; Heart Valve Diseases; Humans
PubMed: 27590452
DOI: 10.1093/eurheartj/ehw354 -
Preventing Chronic Disease Jan 2019Differences in dietary intake and physical activity may explain the higher prevalence of obesity among adolescents living in rural versus urban settings. The objective...
INTRODUCTION
Differences in dietary intake and physical activity may explain the higher prevalence of obesity among adolescents living in rural versus urban settings. The objective of this cross-sectional secondary analysis was to compare baseline dietary intake and physical activity of adolescents by rurality.
METHODS
We analyzed data on 940 adolescents who participated in ACTION PAC (Adolescents Committed to Improvement of Nutrition and Physical Activity), an obesity prevention and management intervention trial conducted from 2014 through 2017 in 8 public high schools in the southwestern United States. Dietary intake was assessed with the Block Food Screener, and participants completed an exercise log and wore an accelerometer to provide data on physical activity. We compared data by rural-urban commuting area (RUCA) codes and log population density by using multilevel models, with students nested within zip code and repeated measures for accelerometer analysis.
RESULTS
After adjusting for socioeconomic status and ethnicity, accelerometer data indicated that moderate-to-vigorous physical activity was 8.17 min/d (P = .02) higher and sedentary time was 20.42 min/d (P = .02) lower in moderately urban areas than in the urban reference area. Each 1-unit increase in log population density was associated with higher reported intake of whole grains (0.02 ounce equivalents, P = .03), potatoes (0.01 cup equivalents, P = .02), and added sugar (0.37 tsp, P = .02) after adjusting for socioeconomic status and ethnicity.
CONCLUSION
Differences in reported dietary intake and physical activity level by measures of rurality were small and inconsistent in direction to explain the disparities observed in rural versus urban areas.
Topics: Adolescent; Adolescent Behavior; Cross-Sectional Studies; Eating; Exercise; Female; Humans; Male; Nutrition Surveys; Nutritional Status; Rural Population; Socioeconomic Factors; Southwestern United States; Urban Population
PubMed: 30605423
DOI: 10.5888/pcd16.180200 -
Journal of Translational Internal... Apr 2016Recent recommendations that limits to dietary cholesterol be dropped were probably heavily influenced by propaganda from the egg industry. After conviction for false... (Review)
Review
Recent recommendations that limits to dietary cholesterol be dropped were probably heavily influenced by propaganda from the egg industry. After conviction for false advertising, the industry has spent hundreds of millions of dollars to convince the public, physicians, and policy makers that dietary cholesterol and egg yolk are harmless. However, there are good reasons for longstanding recommendations that dietary cholesterol be limited to <200 mg/ day in persons at risk of vascular disease. It is seldom understood that this essentially means all people in developed countries who expect to attain an advanced age. There is abundant evidence that dietary cholesterol increases cardiovascular risk. The misdirection of the egg industry focuses on fasting levels of LDL cholesterol, which are only raised by ~ 10% by consumption of egg yolks. However, the main effect of diet is on the post-prandial state: for ~ 4 hours after a high fat/high cholesterol meal, there is oxidative stress, endothelial dysfunction, and arterial inflammation. One large (65 g) egg yolk contains 237 mg of cholesterol, well above the recommended limit-nearly as much as a 12-ounce hamburger. Besides the very high cholesterol content of egg yolk, the phosphatidylcholine in egg yolk leads, via action of the intestinal microbiome, to production of trimethylamine n-oxide (TMAO), which causes atherosclerosis in animal models. Levels of TMAO in the top quartile after a test dose of two egg yolks were associated with a 2.5-fold increase in the 3-year risk of stroke, death, or myocardial infarction among patients referred for coronary angiography. Persons at risk of cardiovascular disease should limit their intake of cholesterol and egg yolk.
PubMed: 28191513
DOI: 10.1515/jtim-2016-0005 -
Vascular Health and Risk Management 2019Spironolactone, an antagonist of aldosterone, initially used as a potassium-sparing diuretic, was subsequently shown to be a very effective adjunctive agent in the... (Review)
Review
Spironolactone, an antagonist of aldosterone, initially used as a potassium-sparing diuretic, was subsequently shown to be a very effective adjunctive agent in the treatment of patients with heart failure with reduced ejection fraction, by halting the disease progression, with significant beneficial effects on both morbidity and mortality. Other uses comprise resistant hypertension, edema in patients with cirrhosis, and other on- and off-label uses. Recent data indicate that spironolactone also may offer some symptomatic relief in patients with heart failure and preserved ejection fraction. However, a variable percentage of patients, particularly among the aged group, may have difficulty in swallowing or may be unable to swallow tablets and thus are deprived of the benefits of such therapy. In 2017, the FDA approved a liquid suspension formulation of spironolactone, CaroSpir, which will enable more heart failure and other patients in need of aldosterone inhibition to avail themselves of the protective and beneficial effects of spironolactone. The new drug formulation comes as a banana-flavored oral suspension that contains 25 mg/5 mL of spironolactone, supplied in 4-ounce (118 mL) and 16-ounce (473 mL) bottles. The details of this drug formulation development and the benefits of spironolactone use in patients with heart failure with a focus on patient selection are herein reviewed.
Topics: Administration, Oral; Clinical Decision-Making; Diuretics; Dosage Forms; Drug Compounding; Flavoring Agents; Heart Failure; Humans; Mineralocorticoid Receptor Antagonists; Patient Selection; Risk Factors; Spironolactone; Treatment Outcome
PubMed: 31920323
DOI: 10.2147/VHRM.S210150 -
International Journal of Radiation... Oct 2020
Review
Topics: Azithromycin; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Hydroxychloroquine; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Randomized Controlled Trials as Topic; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 32890500
DOI: 10.1016/j.ijrobp.2020.08.001 -
Journal of Nutritional Science 2022Some consider potatoes to be unhealthy vegetables that may contribute to adverse cardiometabolic health outcomes. We evaluated the association between potato consumption...
Some consider potatoes to be unhealthy vegetables that may contribute to adverse cardiometabolic health outcomes. We evaluated the association between potato consumption (including fried and non-fried types) and three key cardiometabolic outcomes among middle-aged and older adults in the Framingham Offspring Study. We included 2523 subjects ≥30 years of age with available dietary data from 3-d food records. Cox-proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for hypertension, type 2 diabetes or impaired fasting glucose (T2DM/IFG), and elevated triglycerides, adjusting for anthropometric, demographic and lifestyle factors. In the present study, 36 % of potatoes consumed were baked, 28 % fried, 14 % mashed, 9 % boiled and the rest cooked in other ways. Overall, higher total potato intake (≥4 . <1 cup-equivalents/week) was not associated with risks of T2DM/IFG (HR 0⋅97, 95 % CI 0⋅81, 1⋅15), hypertension (HR 0⋅95; 95 % CI 0⋅80, 1⋅12) or elevated triglycerides (HR 0⋅99, 95 % CI 0⋅86, 1⋅13). Stratified analyses were used to evaluate effect modification by physical activity levels and red meat consumption, and in those analyses, there were no adverse effects of potato intake. However, when combined with higher levels of physical activity, greater consumption of fried potatoes was associated with a 24 % lower risk (95 % CI 0⋅60, 0⋅96) of T2DM/IFG, and in combination with lower red meat consumption, higher fried potato intake was associated with a 26 % lower risk (95 % CI 0⋅56, 0⋅99) of elevated triglycerides. In this prospective cohort, there was no adverse association between fried or non-fried potato consumption and risks of T2DM/IFG, hypertension or elevated triglycerides.
Topics: Aged; Diabetes Mellitus, Type 2; Glucose; Humans; Hypertension; Middle Aged; Outcome Assessment, Health Care; Prospective Studies; Solanum tuberosum; Triglycerides
PubMed: 36117546
DOI: 10.1017/jns.2022.65 -
Annals of Oncology : Official Journal... Sep 2014The late effects of cancer treatment have recently gained a worldwide interest among reproductive endocrinologists, oncologists, and all health-care providers, and the... (Review)
Review
The late effects of cancer treatment have recently gained a worldwide interest among reproductive endocrinologists, oncologists, and all health-care providers, and the protection against iatrogenic infertility caused by chemotherapy assumes a high priority. Here, we summarize the case for and against using GnRH-agonist for fertility preservation and minimizing chemotherapy-induced gonadotoxicity. The rationale and philosophy supporting its use is that preventing premature ovarian failure (POF) is preferable to treating it, following the dictum: 'an ounce of prevention is worth a pound of cure'. Despite many publications on this subject, there are many equivocal issues necessitating summary. Until now, 20 studies (15 retrospective and 5 randomized, controlled trials) have reported on 1837 patients treated with GnRH-a in parallel to chemotherapy, showing a significant decrease in POF rate in survivors versus 9 studies reporting on 593 patients, with results not supporting GnRH-a use. Patients treated with GnRH-a in parallel to chemotherapy preserved their cyclic ovarian function in 91% of cases when compared with 41% of controls, with a pregnancy rate of 19-71% in the treated patients. Furthermore, seven meta-analyses have concluded that GnRH-a are beneficial and may decrease the risk of POF in survivors. However, controversy still remains regarding the efficiency of GnRH-a in preserving fertility. Since not all the methods involving fertility preservation are unequivocally successful and safe, these young patients deserve to be informed of all the various modalities to minimize gonadal damage and preserve ovarian function and future fertility. Combining several methods for a specific patient may increase the odds for minimally invasive fertility preservation.
Topics: Adult; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Female; Fertility; Fertility Preservation; Gonadotropin-Releasing Hormone; Humans; Middle Aged; Neoplasms; Ovary; Pregnancy; Primary Ovarian Insufficiency; Young Adult
PubMed: 24651411
DOI: 10.1093/annonc/mdu036 -
European Journal of Nutrition Sep 2023To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose,...
PURPOSE
To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, central obesity, and blood pressure.
METHODS
This cross-sectional analysis used data from 22,687 adults (aged ≥ 18 years) involved in seven cycles (2005-2018) of the National Health and Nutrition Examination Survey (NHANES). Habitual nut and seed intakes were estimated by the Multiple Source Method using data from two 24-h dietary recalls. Metabolic syndrome was ascertained using biochemical data and self-reported medication use. Sex-specific effect estimates were obtained using logistic and linear regressions adjusting for lifestyle and socioeconomic confounders.
RESULTS
Compared to non-consumers, female, but not male, habitual consumers of either nuts or seeds had lower odds of having metabolic syndrome (OR: 0.83, 95% CI 0.71, 0.97). Both nut intake alone and seed intake alone were inversely associated with high fasting glucose and low HDL-cholesterol in females compared to non-consumers. When restricted to habitual consumers only, the combined intake of nuts and seeds at 6 g/day was associated with the lowest triglycerides and highest HDL-cholesterol in females. Combined consumption of nuts and seeds up to one ounce-equivalent (15 g) per day, but not in higher intake levels, was inversely associated with metabolic syndrome, high fasting glucose, central obesity, and low HDL-cholesterol in females.
CONCLUSIONS
Nut and seed consumption, both separately or combined, below 15 g/day was inversely associated with metabolic syndrome and its component conditions in females but not males.
Topics: Adult; Male; Humans; Female; Metabolic Syndrome; Nutrition Surveys; Nuts; Obesity, Abdominal; Cross-Sectional Studies; Obesity; Diet; Triglycerides; Seeds; Cholesterol, HDL; Glucose
PubMed: 37115204
DOI: 10.1007/s00394-023-03157-1 -
Plastic and Reconstructive Surgery.... May 2022Preoperative risk calculators provide individualized risk assessment and stratification for surgical patients. Recently, several general surgery-derived models have been...
UNLABELLED
Preoperative risk calculators provide individualized risk assessment and stratification for surgical patients. Recently, several general surgery-derived models have been applied to the plastic surgery patient population, and several plastic surgery-specific calculators have been developed. In this scoping review, the authors aimed to identify and critically appraise risk calculators implemented in postmastectomy breast reconstruction.
METHODS
A systematic review of the literature was conducted. Included studies described the development of a novel risk calculator, or validation of an existing calculator, in postmastectomy breast reconstruction.
RESULTS
In total, 4641 studies met criteria for title and abstract screening. Forty-seven were eligible for full-text review, and 28 met final inclusion criteria. The most common risk calculators included the Breast Reconstruction Risk Assessment score (n = 6 studies), modified frailty index (n = 3), Caprini score (n = 3), and ACS NSQIP calculator (n = 2). Calculators were applied to institutional data (n = 17), NSQIP (n = 6), and Tracking Outcomes in Plastic Surgery (n = 1) databases. Predicted outcomes included general postoperative complications (n = 17), venous thromboembolism/pulmonary embolism (n = 4), infection (n = 2), and patient reported outcomes (n = 2). Model accuracy was reported in 18 studies, and it varied significantly (accurate risk calculator 0.49-0.85).
CONCLUSIONS
This is the first study to provide a systematic review of available risk calculators for breast reconstruction. Models vary significantly in their statistical basis, predicted outcomes, and overall accuracy. Risk calculators are valuable tools that may aid in individualized risk assessments, preoperative counseling, and expectation management in breast reconstruction.
PubMed: 35702532
DOI: 10.1097/GOX.0000000000004324